PMV research group, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Department of Medicine, ABDA - Federal Union of German Associations of Pharmacists, Berlin, Germany.
Clin Pharmacol Ther. 2019 Jul;106(1):211-218. doi: 10.1002/cpt.1378. Epub 2019 Mar 12.
Medication adherence correlates with morbidity and mortality in patients with chronic heart failure (CHF), but is difficult to assess. We conducted a retrospective methodological cohort study in 3,808 CHF patients, calculating adherence as proportion of days covered (PDC) utilizing claims data from 2010 to 2015. We aimed to compare different parameters' influence on the PDC of elderly CHF patients exemplifying a complex chronic disease. Investigated parameters were the assumed prescribed daily dose (PDD), stockpiling, and periods of hospital stay. Thereby, we investigated a new approach using the PDD assigned to different percentiles. The different dose assumptions had the biggest influence on the PDC, with variations from 41.9% to 83.7%. Stockpiling and hospital stays increased the values slightly. These results queries that a reliable PDC can be calculated with an assumed PDD. Hence, results based on an assumed PDD have to be interpreted carefully and should be presented with sensitivity analyses to show the PDC's possible range.
药物依从性与慢性心力衰竭（CHF）患者的发病率和死亡率相关，但难以评估。我们对 3808 例 CHF 患者进行了回顾性方法学队列研究，利用 2010 年至 2015 年的索赔数据，计算了药物覆盖率（PDC）作为比例的天数。我们旨在比较不同参数对老年 CHF 患者 PDC 的影响，以说明一种复杂的慢性病。研究的参数是假定的每日剂量（PDD）、囤药和住院时间。因此，我们使用分配给不同百分位数的 PDD 研究了一种新方法。不同的剂量假设对 PDC 的影响最大，从 41.9%到 83.7%不等。囤药和住院时间略微增加了这些值。这些结果表明，一个可靠的 PDC 可以通过假定的 PDD 计算出来。因此，基于假定 PDD 的结果必须谨慎解释，并应进行敏感性分析，以显示 PDC 的可能范围。
